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Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues
Opioids have a rapid transplacental passage (i.e., less than 60 min); furthermore, symptoms characterize the maternal and fetal withdrawal syndrome. Opioid withdrawal significantly impacts the fetus, inducing worse outcomes and a risk of mortality. Moreover, neonatal abstinence syndrome (NAS) follow...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866828/ https://www.ncbi.nlm.nih.gov/pubmed/36668788 http://dx.doi.org/10.3390/toxics11010062 |
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author | Albano, Giuseppe Davide La Spina, Corinne Pitingaro, Walter Milazzo, Vanessa Triolo, Valentina Argo, Antonina Malta, Ginevra Zerbo, Stefania |
author_facet | Albano, Giuseppe Davide La Spina, Corinne Pitingaro, Walter Milazzo, Vanessa Triolo, Valentina Argo, Antonina Malta, Ginevra Zerbo, Stefania |
author_sort | Albano, Giuseppe Davide |
collection | PubMed |
description | Opioids have a rapid transplacental passage (i.e., less than 60 min); furthermore, symptoms characterize the maternal and fetal withdrawal syndrome. Opioid withdrawal significantly impacts the fetus, inducing worse outcomes and a risk of mortality. Moreover, neonatal abstinence syndrome (NAS) follows the delivery, lasts up to 10 weeks, and requires intensive management. Therefore, the prevention and adequate management of NAS are relevant public health issues. This review aims to summarize the most updated evidence in the literature regarding toxicological, clinical, and forensic issues of intrauterine exposure to opioids to provide a multidisciplinary, evidence-based approach for managing such issues. Further research is required to standardize testing and to better understand the distribution of opioid derivatives in each specimen type, as well as the clinically relevant cutoff concentrations in quantitative testing results. A multidisciplinary approach is required, with obstetricians, pediatricians, nurses, forensic doctors and toxicologists, social workers, addiction specialists, and politicians all working together to implement social welfare and social services for the baby when needed. The healthcare system should encourage multidisciplinary activity in this field and direct suspected maternal and neonatal opioid intoxication cases to local referral centers. |
format | Online Article Text |
id | pubmed-9866828 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98668282023-01-22 Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues Albano, Giuseppe Davide La Spina, Corinne Pitingaro, Walter Milazzo, Vanessa Triolo, Valentina Argo, Antonina Malta, Ginevra Zerbo, Stefania Toxics Review Opioids have a rapid transplacental passage (i.e., less than 60 min); furthermore, symptoms characterize the maternal and fetal withdrawal syndrome. Opioid withdrawal significantly impacts the fetus, inducing worse outcomes and a risk of mortality. Moreover, neonatal abstinence syndrome (NAS) follows the delivery, lasts up to 10 weeks, and requires intensive management. Therefore, the prevention and adequate management of NAS are relevant public health issues. This review aims to summarize the most updated evidence in the literature regarding toxicological, clinical, and forensic issues of intrauterine exposure to opioids to provide a multidisciplinary, evidence-based approach for managing such issues. Further research is required to standardize testing and to better understand the distribution of opioid derivatives in each specimen type, as well as the clinically relevant cutoff concentrations in quantitative testing results. A multidisciplinary approach is required, with obstetricians, pediatricians, nurses, forensic doctors and toxicologists, social workers, addiction specialists, and politicians all working together to implement social welfare and social services for the baby when needed. The healthcare system should encourage multidisciplinary activity in this field and direct suspected maternal and neonatal opioid intoxication cases to local referral centers. MDPI 2023-01-09 /pmc/articles/PMC9866828/ /pubmed/36668788 http://dx.doi.org/10.3390/toxics11010062 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Albano, Giuseppe Davide La Spina, Corinne Pitingaro, Walter Milazzo, Vanessa Triolo, Valentina Argo, Antonina Malta, Ginevra Zerbo, Stefania Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues |
title | Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues |
title_full | Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues |
title_fullStr | Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues |
title_full_unstemmed | Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues |
title_short | Intrauterine and Neonatal Exposure to Opioids: Toxicological, Clinical, and Medico-Legal Issues |
title_sort | intrauterine and neonatal exposure to opioids: toxicological, clinical, and medico-legal issues |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866828/ https://www.ncbi.nlm.nih.gov/pubmed/36668788 http://dx.doi.org/10.3390/toxics11010062 |
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